This Mayo Clinic Q and A article originally published Sept. 10, 2016.

DEAR MAYO CLINIC: Six months ago, after becoming pregnant for the first time, I had a miscarriage at 12 weeks. My husband and I want to become pregnant again, but we’re worried about another miscarriage. Are there things I can do to prevent it this time? I’m 27 years old, and I don’t have any health problems.

ANSWER: Having a miscarriage can be shocking, stressful and sad. It’s understandable that you want to do everything you can to avoid going through it again. Although there are some steps you may be able to take to lower your risk of another miscarriage, in most cases, a miscarriage isn’t related to anything a pregnant woman did or did not do. The majority of miscarriages are due to chromosomal abnormalities that happen for no clear reason. Many women who have a miscarriage go on to have normal pregnancies and deliver healthy babies.

In general, a miscarriage is defined as the loss of a pregnancy before 20 weeks gestation. Because it is not a topic that receives much attention, miscarriage tends to be more common than people might think. Doctors estimate that up to 25 percent of all recognized pregnancies end in miscarriage.

Most miscarriages happen because the fetus isn’t developing normally. Problems with the baby’s genes or chromosomes are usually the result of errors that occur by chance as the embryo divides and grows. They typically aren’t due to an inherited disorder, and usually aren’t caused by a mother’s behavior or health.

"Although there are some steps you may be able to take to lower your risk of another miscarriage, in most cases, a miscarriage isn’t related to anything a pregnant woman did or did not do."
- Dr. Yvonne Butler Tobah

That said, there are a few risk factors that can raise the chances of having a miscarriage. Among the most significant is advanced maternal age. This one doesn’t apply to you right now, and it won’t for some time. Women older than 35 have a higher risk of miscarriage than do younger women. At 35, the risk of miscarriage is about 20 percent risk. At 40, it goes up to about 40 percent. At 45, it’s about 80 percent.

Another risk factor that doesn’t sound like it fits your situation is having certain medical conditions. Some disorders that may raise the risk of a miscarriage include uncontrolled diabetes, high blood pressure, thyroid disease, infections, hormonal problems and problems with the uterus or cervix.

When it comes to lifestyle choices you can control, it is important to avoid smoking, drinking alcohol or using illegal drugs when you are pregnant. Not only do these activities raise your risk for a miscarriage, they endanger the health of your baby throughout pregnancy. If you are on prescription medication, ask your doctor if it’s safe to continue taking that medication during pregnancy.

Staying at a healthy weight before you become pregnant and throughout your pregnancy may also help ensure your baby’s health. Being underweight or overweight appears to be linked to an increased risk of miscarriage, as well as other health concerns during pregnancy. For example, women who are significantly overweight are more likely to develop gestational diabetes.

None of the following activities cause miscarriage: lifting, straining, having sex or exercising.

If you have questions or concerns about becoming pregnant again, talk to your health care provider. He or she can review your health and family history, talk with you about risk factors and discuss any preconception care that could be helpful.

As you go forward, please keep in mind that, in almost all cases, miscarriages are beyond a mother’s control. If you become pregnant again, unless an underlying medical condition is identified that needs special care, you shouldn’t need to do anything differently. Get regular prenatal care and focus on taking care of yourself and your baby. — Dr. Yvonne Butler Tobah, Obstetrics and Gynecology, Mayo Clinic, Rochester, Minn.

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DEAR MAYO CLINIC: Six months ago, after becoming pregnant for the first time, I had a miscarriage at 12 weeks. My husband and I want to become pregnant again, but we’re worried about another miscarriage. Are there things I can do to prevent it this time? I’m 27 years old, and I don’t have any health problems.

ANSWER: Having a miscarriage can be shocking, stressful and sad. It’s understandable that you want to do everything you can to avoid going through it again. Although there are some steps you may be able to take to lower your risk of another miscarriage, in most cases, a miscarriage isn’t related to anything a pregnant woman did or did not do. The majority of miscarriages are due to chromosomal abnormalities that happen for no clear reason. Many women who have a miscarriage go on to have normal pregnancies and deliver healthy babies.

In general, a miscarriage is defined as the loss of a pregnancy before 20 weeks gestation. Because it is not a topic that receives much attention, miscarriage tends to be more common than people might think. Doctors estimate that up to 25 percent of all recognized pregnancies end in miscarriage.

Most miscarriages happen because the fetus isn’t developing normally. Problems with the baby’s genes or chromosomes are usually the result of errors that occur by chance as the embryo divides and grows. They typically aren’t due to an inherited disorder, and usually aren’t caused by a mother’s behavior or health.

That said, there are a few risk factors that can raise the chances of having a miscarriage. Among the most significant is advanced maternal age. This one doesn’t apply to you right now, and it won’t for some time. Women older than 35 have a higher risk of miscarriage than do younger women. At 35, the risk of miscarriage is about 20 percent risk. At 40, it goes up to about 40 percent. At 45, it’s about 80 percent.

Another risk factor that doesn’t sound like it fits your situation is having certain medical conditions. Some disorders that may raise the risk of a miscarriage include uncontrolled diabetes, high blood pressure, thyroid disease, infections, hormonal problems and problems with the uterus or cervix.

When it comes to lifestyle choices you can control, it is important to avoid smoking, drinking alcohol or using illegal drugs when you are pregnant. Not only do these activities raise your risk for a miscarriage, they endanger the health of your baby throughout pregnancy. If you are on prescription medication, ask your doctor if it’s safe to continue taking that medication during pregnancy.

Staying at a healthy weight before you become pregnant and throughout your pregnancy may also help ensure your baby’s health. Being underweight or overweight appears to be linked to an increased risk of miscarriage, as well as other health concerns during pregnancy. For example, women who are significantly overweight are more likely to develop gestational diabetes.

None of the following activities cause miscarriage: lifting, straining, having sex or exercising.

If you have questions or concerns about becoming pregnant again, talk to your health care provider. He or she can review your health and family history, talk with you about risk factors and discuss any preconception care that could be helpful.

As you go forward, please keep in mind that, in almost all cases, miscarriages are beyond a mother’s control. If you become pregnant again, unless an underlying medical condition is identified that needs special care, you shouldn’t need to do anything differently. Get regular prenatal care and focus on taking care of yourself and your baby. — Dr. Yvonne Butler Tobah, Obstetrics and Gynecology, Mayo Clinic, Rochester, Minn.

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Acid reflux and heartburn are common digestive conditions that many people experience from time to time. When these digestive problems happen more often and begin to interfere with your daily life, you may have gastroesophageal reflux disease, known as GERD, which is a chronic digestive disease that occurs when stomach acid flows back into your esophagus. On the next Mayo Clinic Radio program, gastroenterologist Dr. Jeffrey Alexander covers treatment for GERD and how lifestyle changes can improve the condition. Also on the program, obstetrician Dr. Yvonne Butler Tobah discusses the difficult subject of miscarriage. And, sports medicine specialist Dr. Ed Laskowski explains an all-too-common knee injury, the torn anterior cruciate ligament (ACL).

Listen to the program on Saturday, July 9, at 9:05 a.m. CDT, and follow #MayoClinicRadio.

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Listen to the program on Saturday, July 9, at 9:05 a.m. CDT.

Miss the show?  Here's the Mayo Clinic Radio podcast.

Follow #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

Access archived shows.

The post Mayo Clinic Radio: GERD / Miscarriage / ACL Injury appeared first on Mayo Clinic News Network.

ANSWER: Going through a miscarriage can be sad and stressful. Dealing with it more than once is particularly difficult. It is understandable that you want answers about why the miscarriages happened. Unfortunately, it is often hard to find a specific cause. There are several tests, however, that may be able to rule out certain problems that could lead to a miscarriage.

In general, a miscarriage is defined as the loss of a pregnancy before 20 weeks gestation. Because it is not a topic that receives much attention, miscarriage tends to be more common than people might think. Doctors estimate that about 10 to 15 percent of all recognized pregnancies end in miscarriage. About one percent of women have more than one miscarriage.

Your doctor’s recommendation to wait for testing until after a third miscarriage fits with traditional guidelines. However, as the risk for another pregnancy loss after two miscarriages is similar to the risk after three miscarriages, some physicians will do testing after two.

Many tests can be done to try to find the reason for miscarriages. One of the most common is called parental karyotyping. For this test, a blood sample is taken from both parents and tested for problems within the chromosomes. If any chromosomes are abnormal, that could mean a genetic disorder may be to blame for the miscarriages.

A blood test also may be used to screen for a condition known as antiphospholipid syndrome.  This disease happens when a person’s immune system mistakenly attacks some of the normal proteins in the blood. It is known to cause pregnancy complications, including miscarriage and stillbirth.

An exam called a hysterosalpingogram can be useful, too. It involves injecting contrast dye through the cervix and then using X-ray to examine the uterus and fallopian tubes for any problems that may be leading to a miscarriage. Tests to check for thyroid disease and diabetes are often performed as well. Those diseases may cause complications that could result in a miscarriage. Additional tests also may be helpful depending on your age, medical background and family history.

Even if all this testing is done, the exact cause of miscarriages still cannot be determined for about 50 to 75 percent of couples. On a brighter note, though, many couples who have more than one miscarriage do go on to have a successful pregnancy. Studies suggest that number to be about 60 percent.

The fact that you already have had one healthy pregnancy raises your chances even higher. Research shows that a previous successful pregnancy is one of the most important predictors of being able to carry another baby to term. Of couples in your situation, 70 to 75 percent have another successful pregnancy.

Have a conversation with your doctor about your concerns regarding your miscarriages. If you feel strongly that you would like testing done before you attempt to get pregnant again, talk about that. Under the circumstances, it is a reasonable request.

Keep in mind, too, that in almost all cases, miscarriages are not a result of anything a mother has done or failed to do. So if you decide to become pregnant again, unless an underlying medical condition is identified that needs special care, you should not need to do anything differently. Seek regular prenatal care, avoid known miscarriage risk factors — such as smoking and drinking alcohol — and focus on taking good care of yourself and your baby. — Carl Rose, M.D., Obstetrics and Gynecology, Mayo Clinic, Rochester, Minn.

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